Posts Tagged ‘costs’

$750 billion down the drain

September 24th, 2012

It’s a shocking figure, but that’s how much money the U.S. healthcare system wasted in 2009, according to a just released report from the Institute of Medicine. The report said expensive medical tests, administrative costs, medical fraud and poor prevention contributed to the waste.

The wasted money could provide health insurance coverage for more than 150 million workers, according to the report. And 75,000 deaths might have been prevented if states delivered higher-quality care.

The Institute of Medicine report makes plain that our healthcare system is not getting the best bang for the buck. What we are getting is a raw deal. The U.S. is still spending far more than our First World counterparts on health care, and getting worse outcomes. The fact that our country could have covered 150 million people and prevented needless deaths with that $750 billion is a moral outrage. And the report only covers 2009. How much more money have we squandered in the years before or since? There is nothing fiscally or socially responsible in the way America does health care, and the IOM report proves that.

Sylvia@californiaonecare.org

$397 Billion/year stimulus: healthcare administration monies freed with Single Payer

September 5th, 2012

by Shockwave

My healthcare activism over the years (since nyceve’s activism got me involved in the movement, and Pris from LA and I organized demonstrations for Single Payer in Los Angeles) has taken me places and has taught me a lot.

Today, I am involved representing California OneCare in the Campaign for a Healthy California, Los Angeles chapter, led by the irreplaceable Georgia Brewer of Healthcare for All.  So I am involved in the Business Sub-Committee, and our objective is to sell the next single payer (SB 810? again) bill to be introduced in the California Senate early in 2013.

In our last meeting, we were reviewing Dr. Robert Zarr’s 2008 PowerPoint: Universal Health Care: A Business Case for Single Payer National Health Insurance.

I highly recommend his PowerPoint; it’s full of great stuff and you can download it from the link above.

Two of the slides shocked me and gave me some food for thought that I’d like to share with you.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Keep in mind that these graphs come from a 2003 study in the New England Journal of Medicine, Costs of Health Care Administration in the United States and Canada, published here on the outstanding website of Physicians for a National Health Plan and the Bureau of Labor Statistics.

First notice how the number of administrators skyrockets in the 1990s (probably coinciding with the rise of for-profit health insurance companies when in 1993, employers were no longer required to offer alternatives to HMOs.)  In 2012, it is probably worse and getting even more worse.

No wonder healthcare costs in the U.S. are so much higher than in any other country, and are heading toward 19% of GNP soon ($3 trillion dollars, yes $3 trillion per year).

 

 

 

 

 

 

 

 

 

These are 2007 figures. It is close to 18.5% today based on expert opinions, and these are the 2009 figures for the whole world (US 17.4%).

So now we are getting to where the stimulus comes. Hang in there.

As a point of reference, it is estimated that every doctor pays $82,975/year in administrative costs.

Administrative costs under a single payer healthcare system like in Canada, for example, are much lower.

These are 1999 figures from the New England Journal study:

 

 

 

 

 

 

 

 

 

So single payer administrative costs are 30% of our current costs or less. Other data points are important. Medicare administrative costs are estimated at 7% at worst (at worst). Think of single payer as Medicare for all improved.

So let’s be conservative and say that if we eliminate the administration mess that the insurance companies have brought us by eliminating them, and we implement a single payer system that allows providers to cut their administrative costs, we only cut overall administrative costs by half. So lets say that under a single payer system, administrative costs are reduced to 15% of overall healthcare costs.

Given that healthcare represents, using 2009 figures, 17.3% of our $15.3 trillion GNP (GNP and costs are both higher now), we are talking about reducing administrative costs from $794 billion/year to $397 billion/year.

Yes, it means that a lot of healthcare administrators  will have to find other jobs eventually. But think of this: $397 billion can now be invested in the economy to do other things like infrastructure, alternative energy, education, small business loans, etc.

$397 billion per year!  Now that is a stimulus package.

Look, I am all for the Affordable Care Act (Obamacare).  The ACA will insure more people, lower insurance company profits and inefficiency, and control climbing costs.  But single payer, as it has demonstrated around the world, will offer better outcomes (life expectancy, child mortality), insure everyone (including undocumented workers), and radically lower administrative costs.
Why? Because doctors and providers will only deal with one organization that will pay all bills.

In California alone this may infuse $40 billion/year into the economy, and that is huge.

I think I can sell this idea even to recalcitrant Ayn Rand-type small business owners (with a bit of conscience).  I think it is a no-brainer.

What do you think?

Shockwave (aka Al Saavedra) is a California OneCare board member. Re-posted from The DailyKos.

As many predicted, health insurance costs skyrocketing, insured Americans forgoing care

September 28th, 2011

by nyceve

As the debate played out during the contentious summer of 2009 before the passage of the Affordable Care Act, many were deeply concerned that the insurance industry would escalate its war against the American people. We feared and predicted even more egregious price gouging.

It seems all our fears were justified.

As we know, even insured Americans are delaying or forgoing needed and necessary healthcare because the high deductible junk insurance they have (which is all they can afford), requires huge out-of-pocket costs, making healthcare a luxury. And please keep in mind, we’re talking about people with insurance. Insured Americans are consuming less health not because they don’t need to see a doctor, but because they can’t afford to do so. This is what the insurers want, they collect our premiums, sell us high deductible insurance which we can’t even afford to use.

A new study just released by the Kaiser Family Foundation paints as grim a picture of the U.S. healthcare system and its unaffordability, as I have ever read. It is ghastly and our healthcare system is on the precipice of collapse.

After several years of relatively modest premium increases, annual premiums for employer-sponsored family health coverage increased to $15,073 this year, up 9 percent from last year, according to the Kaiser Family Foundation/Health Research & Educational Trust 2011 Employer Health Benefits Survey released today.  On average, workers pay $4,129 and employers pay $10,944 toward those annual premiums.
Premiums increased significantly faster than workers’ wages (2.1 percent) and general inflation (3.2 percent).  Since 2001, family premiums have increased 113 percent, compared with 34 percent for workers’ wages and 27 percent for inflation.

“This year’s nine percent increase in premiums is especially painful for workers and employers struggling through a weak recovery,” Kaiser President and CEO Drew Altman, Ph.D. said.

You should not be surprised at this terrible and deeply demoralizing state of affairs. There is little (or nothing) in the Affordable Care Act which requires insurers to make their junk products affordable. Even worse, despite paying a huge percentage of our dwindling income to buy insurance, Americans are paying for almost useless policies. I define a useless policy as one with high deductibles and high out-of-pocket costs.  As the economy continues to show little or no improvement, even workers with insurance are not getting the care they need to do all the costs they are expected to shoulder.

And to make a bad situation even more troubling, the added benefits, insurers are now required to provide due to the passage of the Affordable Care Act, are giving them the cover to raise rates to unconscionable levels and ‘blame’ the ACA.

Throughout this year, major health insurers have defended higher premiums — and higher profits — saying that their expenses would rise once the economy recovered and people believed they could again afford medical care. The struggling economy will probably keep suppressing demand for medical care, particularly as people pay a larger share of their own medical bills through higher deductibles and co-payments, according to benefits consultants and others. About three-quarters of workers now pay part of the bill when they go see a doctor, and nearly a third have a deductible of at least $1,000 if they have single coverage, up from just one in 10 in 2006, according Kaiser.

The Affordable Care Act was written without teeth or strong enforcement mechanisms, but that is old, sad news.  To be fair, the ACA allocates money to the states to police rate hikes, but it is powerless to stop them, and many believe this is really window dressing to give cover to the politicians and to make the very gullible American people think the government is trying to bring us some relief.

Every  day in America, 3,700 families file for bankruptcy caused by illness and medical bills, and that number is rising. This shameful situation happens in no other wealthy democracy. It would be a scandal anywhere else. Most medically bankrupt families were middle-class before they suffered financial setbacks. Roughly 60 percent of them had attended college; 20 percent of families included a military veteran or active-duty soldier.

Most astoundingly, 60 percent of the individuals whose illness led to bankruptcy had private, for-profit health insurance when they got sick. Don’t we buy health insurance to avoid financial ruin? High deductibles lead directly to bankruptcy and foreclosure. To make matters worse, they cause people to postpone needed care. All of which lead to higher insurance company profits.

You should be very, very scared to be an American citizen. I’m sorry to say this, it’s the truth.

Nyceve is a board member for California OneCare. Originally posted in the DailyKos.

Don McCanne, MD: National Health Expenditures in 2011 and 2020

August 12th, 2011

National Health Spending Projections Through 2020: Economic Recovery And Reform Drive Faster Spending Growth

From the Office of the Actuary, Centers for Medicare and Medicaid Services
Health Affairs, July 28, 2011

National Health Expenditures, billions:
2011 – $2,708.4
2020 – $4,638.4

National Health Expenditures, per capita:
2011 – $8,648.5
2020 – $13,708.8

National Health Expenditures, as percent of GDP:
2011 – 17.7%
2020 – 19.8%

http://content.healthaffairs.org/content/early/2011/07/27/hlthaff.2011.0662.full

Comment:

By Don McCanne, MD

This year we are spending $2.7 trillion on health care, or about $8,650 per person. What can we expect after the Patient Protection and Affordable Care Act is fully implemented? In 2020, we will be spending over $4.6 trillion, or about $13,700 per person. As a percent of GDP, our health care spending will increase from the current 17.7 percent to almost 20 percent.

Is the Affordable Care Act really affordable? A single payer national health program would be effective in controlling costs, but, much more importantly, it would ensure that all of us – no exceptions – would receive the health care that we need. The Affordable Care Act will cost us more while leaving far too many broke and without health care.

We can still have the health care system that we need, but we’ll have to replace our dysfunctional representatives in Congress. Can we do that?

Re-posted with permission from pnhp.org.